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enoxaparin (Lovenox)
heparin (Calciparin)
warfarin (Coumadin)
Q. Why has my doctor prescribed this type of medication?
A. Anticoagulants are used to prevent blood clots (in the heart, arteries and veins). These medications are often referred to as "blood thinners," though what they really do is decrease the tendency of your blood to clot. Heparin is given intravenously or under the skin, enoxaparin (low molecular weight heparin) is given by injection, often at home, and warfarin is an oral anticoagulant. These drugs are used to:
There are other medications that can make it less likely for your blood to clot. These include so-called antiplatelet agents
like aspirin. These are covered in the section called, Platelet Inhibitors.
Q. Are there any special precautions that I need to be aware of before I start this type of medication?
A. Please carefully review the general guidelines in this section. Talk with your doctor, nurse and/or pharmacist. Tell them if you:
- Are taking any other medication, prescription or non-prescription, including vitamins and herbs. They can affect the amount of anticoagulant you will need to effectively "thin" the blood.
- Have any medical conditions, especially bleeding problems such as heavy menstrual periods; or history of an ulcer, anemia, or other blood disorder; or liver or kidney disease
Q. What is the proper way to take these medications?
A. Follow these guidelines:
- Take these medications exactly as directed. Do not change the dosage without consulting with your doctor. If you forget a dose, take it as soon as you remember. Do not take double doses. If you miss two or more doses, call your doctor.
- Be sure to have the appropriate periodic blood tests done as ordered so that the dosage can be adjusted to achieve the maximum benefit. If you are taking warfarin (Coumadin), you should have your blood checked for the anticoagulant effect no less often than once per month. The blood test used to monitor warfarin is called the protime and it is reported as two numbers: the protime in seconds (often between 17 and 23 seconds) and the INR (International Normalized Ratio). These tests determine whether your coumadin is at the proper dose. Ask your doctor or nurse your INR goal while you are taking warfarin. You should expect to hear from your doctor within 24 hours of every protime blood test. Your doctor's instructions should include the dosage of warfarin (Coumadin) and the timing of your next protime.
- Avoid activities that have a high risk of injury.
- Wear a Medic Alert bracelet to let anyone caring for you know that you are taking a blood thinner.
- Remember that these medications interfere with your body's normal blood clotting mechanism. Be sure to report any unusual bleeding or bruising to your doctor.
- Talk to your doctor about your diet requirements.
- Numerous medicines, both prescription and over-the-counter, can either interfere with or increase the effect of warfarin. Never start taking a new drug, herb or supplement without first checking with your physician or pharmacist. It is especially important to discuss with them what medicines, if any, you could take for regular aches and pains while taking warfarin.
- Discuss alcohol consumption with your doctor.
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Never assume your protime is "OK" just because you haven't heard from your doctor's office.
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Q. What are the possible side effects of this type of medication?
A. Although side effects from anticoagulants are not common, you should report any of the following to your doctor immediately: sudden appearance of bruises; dark or cloudy urine; vomiting up of dark brown material; bleeding gums; excessive menstrual bleeding; new onset of pain such as backache, headache, or abdominal pain; dark, tarry bowel movements; nosebleeds; or fever or chills.
Copyright ©2005 Michigan Heart & Vascular Institute. All rights reserved.
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